Children's Hospital specializes in tough cases, as we report each year during our holiday-season fund-raising campaign. But sometimes, the staff has to treat ailments before a child is even born. My associate, Lynn Ryzewicz, has the story of a girl, a cyst and a happy outcome:

Neither her obstetrician nor the technician had ever seen anything quite like it before.

Alexa Verveer, a deputy associate attorney general, had an uneventful pregnancy until the middle of her fourth month. An ultrasound test revealed a deformity in her unborn first child. A large cyst in the fetus's chest had caused the heart to shift to one side.

The obstetrician and technician didn't know what to tell Verveer--except that she should go to Children's Hospital right away.

Verveer and her husband, Dominic Bianchi, an employee of the Office of U.S. Trade Representative, arrived one day in mid-November 1998, terrified, with ultrasound records in hand.

Kurt Newman, the vice chairman of pediatric surgery, could give them hope. In his 15-year career as a surgeon, he has seen this condition in children almost 30 times. Ten of those cases have been in unborn children.

Newman laid out two possible outcomes for the Bianchi baby. If the cyst grew as the fetus grew, the heart could press on the lung, hindering lung tissue from developing and possibly depriving the baby of enough lung tissue to survive. If the cyst didn't grow as the fetus grew, the heart would shift back into place, allowing the lung to develop normally.

The question was what to do, if anything.

Newman was accompanied by an experienced advisory team. A multidisciplinary group of doctors from Children's and George Washington University School of Medicine meets once a month to discuss difficult cases such as the couple's.

The team decided that the Bianchi fetus should be left alone to see how it developed. Fetuses have strong self-correcting power, Newman said. He convinced the parents that there was a chance the cyst would not grow. The hard part was having to wait and see.

At that point, Newman said, he wanted to establish trust with the couple. Verveer said he succeeded. "His bedside manner and the personal attention he gave us--he could not have been more positive," she said. "We started looking forward to visits."

For the next six weeks, Verveer and Bianchi went to Children's frequently to have the cyst monitored. By the end of December, the cyst wasn't growing. The fetus's heart was shifting back into place. The lung would have a chance to develop normally.

"We got our Christmas present," Dominic Bianchi said.

The final two months of waiting were especially difficult, Newman said. No one was sure what would happen, and doctors didn't want to do anything drastic that might hinder the fetus's self-correcting power.

"You have all this powerful knowledge and powerful technology, and the hard part is knowing when to use it and when to let nature take its course. In this case, it was letting nature take its course," Newman said.

On March 8, Verveer underwent a scheduled Caesarean section at Columbia Hospital for Women.

Newman was on hand so he could operate immediately to remove the mass if the baby was not breathing. Delivery went smoothly, and Leigh was born "yelling up a storm," her mother said.

Bianchi took pictures with his new digital camera--Leigh and her two parents, Leigh with her mother and Newman, Leigh with her father and Newman. Newman stayed with the family for two hours after delivery.

In August, Newman operated on Leigh to remove the cyst to prevent possible infection. She only lost one-sixth of her lung capacity, which is no more than the average asthmatic or smoker, her father said.

The tight relationship between the Bianchi family and Newman is evident. "I felt a sense of identification with them," Newman said. "We're the same age, and I have small children. [During the delivery], I felt like an expectant father."

Verveer said she expects to keep in close touch with Newman. "I talked to him a few days ago, and it turns into a phone call from a friend," she said.

Today, the birthmark on Leigh's side is more noticeable then her surgical scar.

Her mother said she acts like a typical 8-month-old, getting into everything at the family's home in Northwest Washington. Leigh is especially fond of clearing surfaces by pushing things off counters and shelves.

"A day does not go by when I don't think about what a miracle this kid is," Verveer said.

Our goal by Jan. 21: $650,000.

In hand as of Dec. 22: $211,982.84.

TO CONTRIBUTE TO THE CAMPAIGN:

Make a check or money order payable to Children's Hospital and mail it to Bob Levey, The Washington Post, Washington, D.C. 20071.

BY VISA OR MASTERCARD:

Call Post-Haste at 202-334-9000 on a touch-tone phone. Then punch in K-I-D-S, or 5437, and follow instructions.